As people get older, Chronic diseases become common causes of diseases, having multimorbidity. This will lead to have polypharmacy in older patients contributing to the regimen complexity which can affects patients medication adherence, prescribing quality, adverse drug reaction, health related quality of life and death. All these necessitates a clinical intervention such as deprescribing (reducing inappropriate poly-pharmacy). But such intervention should consider older patients decision/willingness in medication discontinuation process as it may affects the ultimate their clinical outcome. Though this has been extensively explored in developed countries, no attempt was made to explore willingness of older adults with chronic disease for discontinuation of inappropriate medications.

Young Professionals Chronic Disease Network (YP-CDN) Ethiopia chapter, has worked with older patients living with chronic diseases and has identified their priorities for advocacy, and were used as an input for this research project.

Novel Oral Anticoagulants (NOACs) are front line medications for the prevention of cerebrovascular accident secondary to cardio-embolism. Recently, NOACs are replacing coumarins since they do not require close monitoring. But, real world evidence was required to evaluate the extent of adherence to these agents. Accordingly, sub-optimal adherence to NOACs was noted based on evidence obtained from a meta-analysis of 1.6 million Atrial Fibrillation (AF) patients. Interventions should be promptly designed to improve the compliance of patients for NOACs. Further, the availability and affordability of these medications should be insured in developing countries to save the lives of individuals who are suffering from AF.

The finding of the study is available from the following link. doi: 10.2174/1570161116666180123111949.

As years pass, there is a paradigm shift in causes of mortality from communicable to non-communicable diseases, the burden of NCDs has intensified globally but as well become a disaster for low income countries.

A specific group that has over a few past years not been involved are the young people and people living with NCDs. Over the years, the role of youth in the struggle has been noticed, special thanks to the many civil societies involving young people I daily activities.

For NCDs specifically; young people should be looked at as; potential patients, strong advocate group and witnesses in the future for the impact done today.

My attendance and participation at the Global NCD Forum 2017 is itself a testimony of youth involvement. What can young people do to fully contribute towards beating NCDs?. Reflecting about my participation at the Forum, I draw lessons on what has been done, what we are doing an what we are planning to do.

Pre Forum meeting; discussions activities and call to action clearly set ground for us as young people and what we can do In preparation for the UN HLM, the call to action once put into specific country contexts will be a powerful tool to use in the fight against NCDs.

Through the several sessions in the workshop, a stepping stone was laid for youth advocates and young people to be fully capacitated to implement youth led programs and activities in their countries in preparation for UN HLM and beyond, looking at 2018 as our lucky year in the NCDs calendar.

Youth involvement in CSOs activities and projects:

Having youth involved in several activities and projects by various CSOs at country level, creating leadership positions for young advocates in the established organizations is one obvious way of having young people own NCD related programs but as well strengthen mobilization for advocacy and building numbers, there we can define meaningful involvement, for programs and events at a regional level, we shall jubilate seeing young people present and involved in the organization.

Capacity building:

The Sharjah pre-forum Youth meeting is enough evidence that we need to support young people through capacity building workshops, fellowships and even mentorships. The impact that was created after the 2 day workshop we had, using the acquired knowledge and skills at the Forum, standing heads up to speak at panels clearly demonstrated the impact left by the workshop we had, this was just 22 youth advocates from 6 WHO regions, What if we had similar workshops organized at a regional level, country level? We shall have built a big network of informed youth and young people ready to make 2018 count. Thanks to CSOs with already existing programs of such, together we shall hit the mark.

Supporting Youth Initiatives:

It is not surprising that out of the youth participants at the Forum, at least everyone is running though small but an activity aimed at improving quality of life and reducing the burden of NCDs. These initiatives once supported and strengthened will accelerate the speed we are moving at towards achieving our targets. The NCD community is such a network whose impact can easily be assessed. Assessing community awareness for instance before and after an intervention, access to essential and quality health care are components whose results can manifest with in a shortest possible time; with youth numbers, we can implement these and reach out to as many as we can. SUPPORT THE YOUTH.

Financing:

NCD work should greatly be financed greatly if we are to reap from our efforts, this trickles down especially to low income countries where health financing is low, but even the less allocated for health never consider NCD as a key priority. If we pushed for increased funding into the sector, then pressurized our states and Health departments to consider NCDs as a key priority, rest assured we shall celebrate in 2018 and beyond.

Mentorship:

My interaction with senior members at the Forum reignited my spirit of listening and understanding what it means to drive an agenda, what it means to achieve a level of success, it was such an opportunity for me to interact with organization leads, decorated Forum speakers and learn from them, this is a dream opportunity for many young advocates out there in the world. We need to create a safe environment for the next generation.

As a youth advocate, my strategies, commitment and dream is to see ourselves together with our mentors celebrate the fruits of our sweat.

Infective Endocarditis (IE) affects the endothelial lining of the heart. its mortality after medical therapy has been poorly reported. only recently, a meta-analysis of more than 22, 000 subjects revealed the short- and long term mortality of IE. Accordingly, the 30-day mortality was found to be 20% whereas 2 out of 5 individuals die of IE after 30- day follow-up. In addition to its burden on mortality; it complicates to cardiac, renal and embolic events. Risk factors such as rheumatic heart diseases, congenital heart diseases, diabetes and substance use should be appropriately managed to reduce this morbidity and mortality.

Readers are suggested to access the full text of the article from the following link.

DOI: 10.1186/s12872-017-0729-5

Short- and long-term outcomes in endocarditis patients: a systematic review and meta-analysis.

Short- and long-term outcomes in endocarditis patients: a systematic review and meta-analysis.